Women Whose Ovarian Cancer Returned Soon After Chemo Survived Longer When a Cortisol Blocker Joined Treatment

CATEGORY: WOMEN’S HEALTH

Researchers wanted to know whether blocking cortisol, the body’s main stress hormone, could help chemotherapy work against ovarian cancer that platinum drugs no longer control. The ROSELLA trial’s answer: women who took the cortisol-blocking pill relacorilant alongside chemotherapy lived a median of 16 months, against 11.9 months with chemotherapy alone.¹ That’s roughly four extra months, and the chance of dying during the study period was 35% lower. The FDA approved the combination in March 2026, so this isn’t a drug readers have to wait for.

Why Block a Stress Hormone to Fight Cancer?

Cortisol is the hormone your adrenal glands release under stress, and it tells cells throughout the body to hunker down and survive. That signal is useful in a famine. It’s much less welcome during chemotherapy, because ovarian tumor cells can use the same survival message to shrug off the self-destruct orders that chemo is trying to deliver. Relacorilant blocks the docking site cortisol uses, stripping the tumor of that shield for a few days at a time. Women in the trial took it on just three days per cycle: the day before each chemotherapy infusion, the day of, and the day after.

381 Women Whose Options Had Thinned

Every woman in the trial had ovarian cancer that had come back within six months of platinum-based chemotherapy, the treatment doctors call “platinum-resistant” disease. All had already been through one to three treatments, including the drug bevacizumab. Few situations in cancer care offer fewer good choices. At 117 hospitals in 14 countries, a computer randomly sorted 381 of these women into two groups: 188 added relacorilant to the chemotherapy drug nab-paclitaxel, and 193 received nab-paclitaxel by itself.² The trial was open label, meaning each woman and her doctor knew which plan she was on. For survival, that openness matters less than it would for softer measures. A date on a death certificate doesn’t bend to anyone’s expectations.

Four Extra Months, and More Women Alive at a Year and a Half

The trial set itself two main goals, survival and time without the cancer growing, and both were met. After a median of about two years of follow-up, median survival reached 16.0 months with relacorilant versus 11.9 months without it. Picture 100 women starting each treatment: eighteen months in, 46 of the relacorilant group were still living, compared with 27 on chemotherapy alone.¹ Time before the cancer progressed also stretched, from 5.5 to 6.5 months. None of this came free. Severe side effects were more common with the combination (75% versus 59%), led by drops in infection-fighting white cells and in red blood cells. One death was judged treatment-related, and investigators attributed it to the chemotherapy rather than to relacorilant. Corcept Therapeutics, which makes relacorilant, funded the trial.

The Other New Option Needs a Biomarker Test. This One Doesn’t

Only one other treatment has extended survival in platinum-resistant ovarian cancer in a randomized trial: the antibody drug mirvetuximab, which added about 3.7 months but works only for tumors carrying high levels of a protein called folate receptor alpha.³ Relacorilant required no such test. The ROSELLA investigators make exactly that point, concluding the combination could become a new standard option “without the need for biomarker selection.” For women whose tumors fail the biomarker screen, this is the first survival-extending option a randomized trial has handed them.

Key Takeaways

• Adding the cortisol blocker relacorilant to chemotherapy extended median survival in platinum-resistant ovarian cancer from 11.9 to 16.0 months, and 46 of every 100 women were alive at 18 months versus 27 of 100 on chemotherapy alone.
• The FDA approved relacorilant (brand name Lifyorli) with nab-paclitaxel in March 2026 for this use, after one to three prior treatments.
• The benefit showed up without any biomarker test, unlike mirvetuximab, the other option proven to extend survival in this setting.
• The added survival carried a cost: severe side effects in 75% of women versus 59% with chemotherapy alone, mostly drops in blood counts.

References

1. Lorusso D, Gladieff L, O’Malley DM, et al. Overall survival with relacorilant and nab-paclitaxel in patients with platinum-resistant ovarian cancer (ROSELLA): a phase 3 randomised controlled trial. The Lancet. 2026;407(10538):1513–1524. link
2. Olawaiye AB, Gladieff L, O’Malley DM, et al. Relacorilant and nab-paclitaxel in patients with platinum-resistant ovarian cancer (ROSELLA): an open-label, randomised, controlled, phase 3 trial. The Lancet. 2025;405(10496):2205–2216. link
3. Moore KN, Angelergues A, Konecny GE, et al. Mirvetuximab Soravtansine in FRα-Positive, Platinum-Resistant Ovarian Cancer. New England Journal of Medicine. 2023;389(23):2162–2174. link