In Italy the ovary tumor It affects 52800 women, with 5,423 new diagnoses in the last year, as can be seen from The numbers of cancer 2024. It is among the top 10 most popular tumor forms among women, with one percentage of survival 5 years after diagnosis which still stands around 43 percent. Precisely for this reason the results of a new study recently published on Lancet and presented together with Conference of the American Society for Clinical Oncology (ASCO), they seem to open important perspectives.
Specifically the Phase III trial Rosellashowed how theuse of an experimental moleculecombined with chemotherapycan be able to improve its effectiveness.
The study was conducted on an international scale, involving 117 centers distributed in 14 countries. In Europe It was coordinated by Sunday Lorusso – now responsible for the Oncological gynecological of Humanitas San Pio X and ordinary teacher of Humanitas University – While he was responsible for UOC Programming Clinical Research of the Agostino Gemelli IRCCS University Polyclinic Foundation in Rome.
«Ovarian carcinoma It is one of the most aggressive and complex gynecological tumors To be treated – explains Professor Sunday Lorusso. – It is a tumor for which we do not have effective screening that is not characterized by specific symptoms. This makes it that in 80% of cases it is diagnosed in an advanced stagefactor that, as we know, conditions the Possibility of successful successso much so that today 5 -year survival for ovarian cancer is still around 50%».
To make the treatment of this pathology particularly complex is also another aspect. “It is A tumor that has a tendency to develop resistance to standard pharmacological treatments – underlines the professor. – 80% of patients respond to the first line of therapy but unfortunately also 80% of those who responded to therapies, recurrence within the first 3 years from the end of the care. And more early is the relapse less chance of success have care. The study we have carried out is important precisely because It is aimed at that category of more difficult patients to treatwhat we call chemotherapy resistantor that they came back within 6 months from the end of platinum -based chemotherapy». (Platinan chemotherapy is a type of anticancer treatment that uses drug -containing drugs capable of acting by damaging the DNA of cancer cells).
Ovarian tumor and cortisol: how the new molecule acts
The new experimental molecule (called Relacorilant), which has shown to improve the effectiveness of chemotherapy, acts specifically blocking the pro-tumor effect of cortisol. Known as “Stress hormone”cortisol regulates numerous physiological processes, such as stress and metabolism, but also carries out a crucial role in cancer progression. Not surprisingly, high levels of cortisol receptors are associated with ovarian cancer patients Particularly unfavorable prognosis.
“We found out that When cortisol is linked to glucocorticoid receptors on cells, Activates the transcription of a series of genes – explains the professor of Humanitas University. – Some, called anti-apoptotic, favor the onset of the diseaseothers make the more resistant disease. The new molecule belongs to a class of compounds called selective antagonists of the glucocorticoid receptor, which they act precisely by interfering with this mechanism and thus making the cancer cells more susceptible to the action of chemotherapy».
How the study took place
The study involved 381 women with ovarian cancer. The participants had already been subjected up to 3 previous disclosures without success. The patients were divided into two groups: the first received one Combination of Relacorlant, The new selective antagonist of the glucocorticoid receptor, together with NAB-Paclitaxel, an agent chemotherapy; The Second group received only NAB-Paclitaxel. The main objective was to evaluate whether the addition of the new molecule could slow down the progression of the disease and improve overall survival. And i Results proved to be promising.
«Refinement is an oral drug that provides for three administrations For each cycle of chemotherapy: it is given the day before, the day of therapy and the next day – explains Professor Lorusso. – This New therapeutic combination has shown to increase Not only does the progression free survivalreducing the risk of progression by 30%, but also of offer an advantage in terms of global survival with an increase of the latter of 30%. An equally important aspect emerged from the study was the Good tolerability of combined treatment: the side effects recorded were similar between the two groups, confirming The safety of this new therapeutic strategy “.
In the face of these important results, the experimental drug could therefore become, combined with the NAB-Paclitaxel, a New standard of treatment For patients with ovarian tumor resistant to therapies. The next steps? «Now that the results of the study have been published, it is activated The approval process for this new therapeutic combination – concludes Lorusso – by the FDA and in parallel of the Ama, and then in Italy with the approval from the AIFA ».
Source: Vanity Fair
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