GnRHa + Letrozole in Non-obese Progestin-insensitive Endometrial Cancer and Atypical Hyperplasia Patients

This study tests whether a combination of GnRHa (a hormone injection that suppresses ovarian function) plus letrozole (a hormone blocker) can treat early-stage uterine cancer or atypical uterine thickening (endometrial atypical hyperplasia) in non-obese women who did not respond to progestin therapy. This fertility-sparing approach is for women who want to avoid a hysterectomy. **You may be eligible if...** - Your biopsy confirmed grade 1 endometrial cancer (EEC G1) or endometrial atypical hyperplasia (EAH), with no spread into the uterine muscle - Your BMI is under 30 kg/m² (not obese) - Imaging (MRI/CT/ultrasound) shows no signs of cancer outside the uterus - You previously tried progestin therapy (megestrol acetate or medroxyprogesterone) and it did not achieve a complete response **You may NOT be eligible if...** - Your cancer has grown into the uterine wall or spread beyond the uterus - You are obese (BMI ≥ 30) - You have not tried progestin-based therapy first Talk to your doctor to see if this trial is right for you.