Phase 2 atorvastatin HMG‑CoA reductase inhibitor immunometabolism add‑on in HGSOC

This University of Colorado Denver–sponsored Phase 2, randomized “window/add-on” study asks whether adding daily atorvastatin (a small‑molecule HMG‑CoA reductase inhibitor that alters cholesterol/mevalonate metabolism and can modulate myeloid immunity) to standard neoadjuvant therapy changes the tumor immune microenvironment in advanced high‑grade serous ovarian, fallopian tube, or primary peritoneal carcinoma. Participants receive 3–4 cycles of carboplatin (platinum DNA crosslinker) plus paclitaxel (microtubule stabilizer), interval debulking surgery, then 2–3 additional cycles of carboplatin/paclitaxel; the experimental arm takes atorvastatin throughout alongside the same chemo-surgery backbone. The key readout is immune profiling of the tumor (especially tumor-promoting macrophages), positioning this as an immune-modulation strategy rather than a new cytotoxic regimen. Today’s care for stage III/IV high‑grade serous disease typically uses carboplatin/paclitaxel with interval debulking when appropriate, then maintenance often includes PARP inhibition in molecularly eligible patients and/or bevacizumab, so the commercial/scientific angle here is a low-cost, widely available metabolic drug being repurposed to reshape macrophage biology around standard treatment.