Study of Relacorilant in Combination With Nab-Paclitaxel for Patients With Recurrent Platinum-Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Relacorilant is a small molecule antagonist of the glucocorticoid receptor (GR). The goals of
this study are to evaluate the efficacy of relacorilant either administered daily
(continuous) or on the day prior, the day of, and the day after chemotherapy (intermittent)
in combination with nab-paclitaxel in the treatment of platinum-resistant ovarian, fallopian
tube, or primary peritoneal cancers compared with nab-paclitaxel alone. The safety,
pharmacokinetics (PK), and pharmacodynamic profile of relacorilant in combination with
nab-paclitaxel will also be assessed.

Eligible patients will be randomized 1:1:1 to one of the following three treatment arms.
Patient randomization will be stratified by treatment-free interval from most recent taxane
(<6 months vs >/=6 months) and presence of ascites (yes vs no).

- Arm A (Continuous): Relacorilant 100mg, administered orally, once daily every day
starting on Cycle 1, Day -7 in combination with nab-paclitaxel on Days 1, 8, and 15 of
each 28-day cycle.

- Arm B (Intermittent): Relacorilant 150mg, administered orally, on the day before, the
day of, and the day after nab-paclitaxel, starting on Cycle 1, Day -1, in combination
with nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.

- Arm C (Comparator): Nab-paclitaxel on Days 1, 8, and 15 of each 28-day cycle.

Patients will remain on treatment until reaching a protocol-defined event of disease
progression (PD), experiencing unmanageable toxicity, or until other treatment
discontinuation criteria are met. All patients will be followed for progression, subsequent
therapies and survival. Patients in Arm C (Comparator) who experience unequivocal PD per
RECIST v1.1 will be given the opportunity to receive relacorilant in combination with
nab-paclitaxel after discussion with the Medical Monitor.

Inclusion Criteria:

- Signed and dated IRB/IEC-approved informed consent form (ICF) prior to study-specific
screening procedures.

- Female patients aged ≥ 18 years old at time of consent.

- Histologic diagnosis of high grade serous or endometrioid epithelial ovarian, primary
peritoneal, or fallopian tube cancer or ovarian carcinosarcoma. Clear cell, mucinous
and borderline histologic subtypes are excluded.

- Received at least one line of therapy with a treatment-free interval after
platinum-based therapy of less than 6 months, persistent disease at the completion of
primary platinum-therapy, or PD during platinum-based therapy.

- Measurable or non-measurable disease by RECIST v1.1:

- Previously irradiated lesions are not allowed as measurable disease, unless there is
documented evidence of progression in the lesions.

- To be eligible with non-measurable disease, patients must have evaluable disease with
CA 125 of ≥ 100 U/mL along with radiographically evaluable disease by CT/MRI.

- Availability and consent to provide tumor tissue for GR immunohistochemistry (archival
or recent biopsy).

- Up to 2 prior chemotherapeutic or myelosuppressive regimens for recurrent disease (not
including maintenance therapy such as single-agent bevacizumab).

- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.

- Adequate organ and bone marrow function meeting the following criteria at the
Screening Visit:

- Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3.

- Platelet count ≥ 100,000/mm3.

- Hemoglobin ≥ 9 g/dL.

- AST or ALT ≤ 2.5 × upper limit of normal (ULN) (or ≤ 5 × ULN in the context of
liver metastasis).

- Total bilirubin ≤ 1.5 × ULN.

- Serum creatinine ≤ 1 × ULN; creatinine clearance ≥ 50 mL/min/1.73 m2 for patients
with creatinine levels above institutional normal.

- Albumin ≥ 3 g/dL (≥ 30 g/L) .

- If patient has undergone surgery of the gastrointestinal or hepatobiliary tract,
adequate absorption as evidenced by: albumin ≥ 3.0 g/dL, controlled pancreatic
insufficiency (if present), and lack of malabsorption.

- Able to swallow and retain oral medication and does not have uncontrolled emesis.

- Able to comply with protocol requirements.

- Negative pregnancy test for patients of childbearing potential. Patients of
childbearing potential must use appropriate precautions to avoid pregnancy, defined as
of non-childbearing potential (ie, postmenopausal or permanently sterilised) or using
highly effective contraception with low user-dependency, for at least 3 months after
the last dose of study drug. A woman is postmenopausal if it is more than 12 months
since her last menstruation, without an alternative medical cause. Accepted methods of
permanent sterilization methods are hysterectomy, bilateral salpingectomy and/or
bilateral oophorectomy. Accepted methods of highly effective contraception with low
user-dependency are:

- An IUD, provided that the subject has tolerated its use for at least 3 months
before the first dose of study medication and undertakes not to have it removed
for 1 month after the last dose.

- Abstinence from heterosexual intercourse, when it is in line with the subject's
preferred and usual lifestyle. Periodic abstinence and withdrawal is NOT
acceptable.

- Vasectomised partner provided that the partner is the sole sexual partner of the
trial participant and that the vasectomised partner has received medical
assessment of the surgical success.

- Oral hormonal contraceptives are NOT permitted.

Exclusion Criteria:

- Clinically relevant toxicity from prior systemic cytotoxic therapies or radiotherapy
that in the opinion of the Investigator has not resolved to Grade 1 or less prior to
randomization.

- Any major surgery within 4 weeks prior to randomization. If subject received major
surgery including (curative or palliative surgery), they must have recovered
adequately from the toxicity and/or complications from the intervention prior to
starting therapy.

- Treatment with the following prior to randomization:

- Concurrent treatment with other anticancer therapy including other chemotherapy,
immunotherapy, radiotherapy, chemo-embolization, targeted therapy, an
investigational agent or the non-approved use of a drug or device within 28 days
before the first dose of study drug.

- Hormonal anticancer therapies within 7 days of the first dose of study drug.

- Systemic, inhaled, or prescription strength topical corticosteroids within 21
days of the first dose of study drug. Short courses (≤ 5 days) for
non-cancer-related reasons are allowed if clinically required (such as
prophylaxis for CT).

- Received radiation to more than 25% of marrow-bearing areas.

- Toxicities of prior therapies (except alopecia) that have not resolved to National
Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0 ≤
Grade 1.

- Requirement for treatment with chronic or frequently used oral corticosteroids for
medical conditions or illnesses (e.g., rheumatoid arthritis, immunosuppression after
organ transplantation).

- History of severe hypersensitivity or severe reaction to either study drug or to
similar classes of either study drug.

- Peripheral neuropathy from any cause > Grade 1.

- Pregnant or lactating patients or patients expecting to conceive children within the
projected duration of the trial, starting with screening visit through 90 days after
the last dose of trial treatment.

- Human immunodeficiency virus or current chronic/active infection with hepatitis C
virus or hepatitis B virus, including:

- Patients with chronic or active hepatitis B as diagnosed by serologic tests are
excluded from the study. In equivocal cases, hepatitis B or C polymerase chain
reaction may be performed and must be negative for enrollment.

- Patient has a clinically significant uncontrolled condition(s) or which in the opinion
of the Investigator may confound the results of the trial or interfere with the
patient's participation, including but not limited to:

- Unstable angina pectoris, angioplasty, cardiac stenting, or myocardial infarction
6 months before study entry.

- Uncontrolled hypertension (sustained systolic blood pressure > 150 mmHg or
diastolic pressure > 100 mmHg despite optimal management). Patients will be
considered eligible if hypertension is treated and controlled during Screening.

- Active infection that requires parenteral antibiotics.

- Bowel obstruction or gastric outlet obstruction.

- Has known psychiatric or substance abuse disorders that would interfere with
cooperation with the requirements of the trial.

- Untreated parenchymal central nervous system metastases.

- Any other concurrent cancer or a history of another invasive malignancy within the
last 3 years that has a likelihood of recurrence of > 30% within the next 5 years.
Adequately treated non-melanoma skin cancers or non-muscle invasive urothelial cancer
or other tumors curatively treated with no evidence of disease are permissible.

- Drugs with a narrow therapeutic ratio that are highly dependent on CYP3A for clearance
should be avoided. Caution should be exercised when co-administering known inhibitors
of CYP3A with relacorilant. Medicines/food known to strongly inhibit CYP3A should be
avoided.

- Concurrent treatment on other Phase 1, 2, or 3 investigational treatment studies for
the treatment of ovarian, fallopian tube, or primary peritoneal cancer.

- Has received a live vaccine within 30 days of planned start of study therapy. Note:
Seasonal influenza vaccines for injection are generally inactivated flu vaccines and
are allowed; however intranasal influenza vaccines (e.g., Flu-Mist®) are live
attenuated vaccines, and are not allowed.