Weight Management Plus Megestrol Acetate in Early-stage Endometrioid Carcinoma

Last updated: August 6, 2025
Sponsor: Xiaojun Chen
Overall Status: Active - Recruiting

Phase

2/3

Condition

Carcinoma

Infertility

Obesity

Treatment

Megestrol Acetate 160 MG Oral Tablet

Intensive Lifestyle Intervention (ILI)

Clinical Study ID

NCT05316467
53211036-01
  • Ages 18-45
  • Female

Study Summary

To investigate the efficacy of weight management plus megestrol acetate in obese patients with early endometrioid carcinoma（EEC）asking for fertility-sparing treatment

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. 18 years≤age≤45years

  2. BMI (body mass index) ≥24kg/m2

  3. Consent informed and signed

  4. Pathologically confirmed as endometrial carcinoma Patients with endometrialspecimens obtained by endometrial biopsy, diagnostic curettage or hysteroscopy anddiagnosed histologically as endometrioid carcinoma, G1. If specimens are from otherhospitals, they must be counseled or reconfirmed by the Department of Pathology ofthe Obstetrics and Gynecology Hospital of Fudan University.

  5. Imaging Assessment Enhanced MRI of the pelvis and enhanced CT of the upper abdomenmust be performed in 2 weeks prior to starting treatment to assess the lesionsconfined to the endometrial layer without clear myometrial infiltration orextrauterine involvement.

  6. Have a strong desire to reproduce and ask for fertility preservation or those whoinsist on keeping the uterus despite no reproductive requirements.

  7. Have good compliance and follow-up conditions, and patients are willing to follow upin Obstetrics and Gynecology Hospital of Fudan University in time.

Exclusion

Exclusion Criteria:

  1. Patients with non-endometrioid endometrial carcinoma, endometrioid endometrialcarcinoma G2/G3 or other malignant tumors of the reproductive system; imagingsuggests myometrial invasion, cervical involvement or extra-uterine involvement.

  2. Combined with severe medical disease or liver or kidney dysfunction: alanineaminotransferase (ALT) or aspartate aminotransferase (AST) levels elevate to 3 timesor more of the upper limit of normal, kidney dysfunction (creatinine clearance <30mL/min)

  3. Patients with other types of endometrial cancer or other malignant tumors of thereproductive system; patients with breast cancer or other hormone-dependent tumorsthat cannot be used with progesterone.

  4. Those who have received high doses of high potency progestin or oral contraceptiveswithin the last 3 months (or those on maintenance medication).

  5. Those who require hysterectomy or other methods other than conservative treatment.

  6. Known or suspected pregnancy.

  7. Those who has contraindications to use progestin.

  8. Deep vein thrombosis, stroke, myocardial infarction.

  9. Severe joint lesions that prevent walking or movement.

Study Design

Total Participants: 89
Treatment Group(s): 2
Primary Treatment: Megestrol Acetate 160 MG Oral Tablet
Phase: 2/3
Study Start date:
May 01, 2022
Estimated Completion Date:
February 28, 2027

Study Description

Background:

High-dosage high-efficacy progesterone, such as Megestrol Acetate (MA) and medroxyprogesterone acetate(MPA), is still the first-line treatment for women with early endometrioid endometrial cancer (EEC) who want to preserve fertility. Approximately 70% to 80% of females who meet the criteria for conservation treatment are able to achieve CR after progestin therapy, with a median time of 6-7 months, but about 20% to 30% of patients get no response or need to take longer time to achieve remission (over one year). Overweight/obesity is an independent risk factor for fertility-sparing treatment response and pregnant outcomes in young females with early endometrioid cancer, substantial evidence showed that obesity can cause relatively lower complete response（CR）rates, longer time to achieve completer remission and lower birth rates besides metabolic disorders and other adverse effects caused by obesity. Weight management has been found to improve metabolic disorders, ovarian functions and pregnant outcomes.The hypothesize is that weight management plus progestin therapy may raise CR rates and pregnant outcomes in young female EEC patients asking for fertility conservation. Previous research has shown that metformin plus MA can increase CR rates. Enhanced lifestyle management (diet control, exercise and daily behavioral guidance) may improve metabolic conditions, increase CR rates and pregnant outcomes in obese EEC patients who want to preserve fertility. Till now, no similar studies were found, so the investigators design this study to explore the efficacy of weight control in EEC fertility-sparing patients to provide new evidence for improving conservative treatment.

Objective: To investigate whether weight management plus MA improve the efficacy of preserving fertility when compared to MA alone in obese women with EEC who want fertility conservation.

Design: This study is two single-arm, prospective, open-label. Patients with early-stage endometrioid carcinoma requiring conservation treatment with BMI ≥ 24 kg/m2 will be recruited in this study and they will be divided into two arms, one is overweight group (24kg/m2≤BMI<28kg/m2) and another is obese group (BMI≥28kg/m2). Each arm and its sample size was designed according to Simon's Two-Stage Design. All enrolled patients will receive enhanced lifestyle management to control weight and take MA for treating EEC. Hysteroscopic examination, metabolic and inflammatory indicators will be performed every 12 to16 weeks while other indexes will be evaluated every month, including weight, heart rates，blood pressure and so on.For the progestin efficacy evaluation, CR is defined as the remission of EEC to proliferative or secretory endometrium; partial response (PR) is defined as regression to simple or complex hyperplasia with or without atypia; no response (NR) is defined as the persistence of the disease; and progressive disease (PD) is defined as disease progression in patients. Two months' maintenance treatment will be recommended for patients with CR, and participants will be followed up for 2 years.

Outcomes: Primary outcome is the CR rates of the two arms (overweight and obesity group). Secondary outcomes include pregnancy rates, live birth rates, weight loss, insulin resistance, chronic inflammation indicators, time to achieve CR and the recurrence rates and so on. Safety and side events during the whole trial will be monitored in two years.

Connect with a study center

  • Obstetrics and Gynecology Hospital, Fudan University

    Shanghai, Shanghai 200011
    China

    Active - Recruiting

Map preview placeholder

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.