Relacorilant — Drug Monograph
Brand names: Lifyorli
Drug class: Other
Mechanism of Action
Oral selective glucocorticoid receptor antagonist (SGRA). By competitively binding the glucocorticoid receptor without agonist activity, relacorilant blocks cortisol-driven signaling that would otherwise suppress apoptosis in tumor cells, thereby restoring and enhancing the pro-apoptotic effect of chemotherapy (nab-paclitaxel). Unlike mifepristone, it does not antagonize the progesterone receptor, avoiding antiprogestin effects.
FDA Indications
- In combination with nab-paclitaxel for adults with platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer who have received one to three prior systemic regimens, at least one of which included bevacizumab (FDA approved March 25, 2026; ROSELLA: median OS 16.0 vs 11.9 months, HR 0.65; PFS HR 0.70)
Common Side Effects
- Decreased hemoglobin/anemia
- Neutropenia
- Fatigue
- Nausea
- Diarrhea
- Thrombocytopenia
- Rash
- Decreased appetite
Clinical Pearl
Relacorilant is the first selective glucocorticoid receptor antagonist approved in oncology. Its pulsed dosing (day before/of/after each nab-paclitaxel dose) reflects its role as a chemosensitizer rather than a continuous cytotoxic. Key practical caveat: because it blocks the glucocorticoid receptor, steroids given as antiemetic or hypersensitivity premedication - or to treat adrenal insufficiency - may be less effective, so watch for adrenal insufficiency.