RecruitingPhase 2Phase 3NCT05316935

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

Gonadotropin-releasing Hormone Agonist (GnRHa) Plus Letrozole in Non-obese Progestin-insensitive Early-stage Endometrial Cancer and Atypical Hyperplasia Patients With Conservative Treatment


Sponsor

Xiaojun Chen

Enrollment

80 participants

Start Date

Jul 13, 2022

Study Type

INTERVENTIONAL

Conditions

Summary

To investigate the efficacy of GnRHa plus letrozole vs Diane-35 plus metformin in non-obese progestin-insensitive early-stage endometrial cancer (EEC) and atypical hyperplasia(EAH) patients asking for conservative treatment.


Eligibility

Sex: FEMALEMin Age: 18 YearsMax Age: 45 Years

Inclusion Criteria12

  • Have a confirmed initial pathological diagnosis based upon hysteroscopy: histologically prove EAH or well-differentiated EEC G1 without myometrial invasion
  • BMI\<30kg/m2
  • No signs of suspicious extrauterine involvement on enhanced magnetic resonance imaging (MRI) or enhanced computed tomography (CT) or ultrasound
  • Using progestin, any of the following therapy, as first-line treatment:
  • Megestrol acetate ≥ 160 mg qd using, combined with Levonorgestrel Lntrauterine System (LNG-IUS) inserted or not
  • Medroxyprogesterone acetate ≥ 250 mg qd using, combined with LNG-IUS inserted or not
  • LNG-IUS inserted
  • Progestin-insensitive:
  • remained with stable disease after 7 months of progestin use
  • did not achieve CR after 10 months of progestin use
  • Have a desire for remaining reproductive function or uterus
  • Good compliance with adjunctive treatment and follow-up

Exclusion Criteria8

  • Combined with severe medical disease or severely impaired liver and kidney function
  • Pathologically confirmed as endometrial cancer with suspicious myometrial invasion or extrauterine metastasis
  • Patients with other types of endometrial cancer or other malignant tumors of the reproductive system
  • Patients with breast cancer or other hormone- dependent tumors or diseases that cannot be used with Diane-35, GnRHa, Letrozole or MET
  • Strong request for uterine removal or other conservative treatment
  • Known or suspected pregnancy
  • Acute severe disease such as stroke or heart infarction or a history of thrombosis disease
  • Smoker(\>15 cigarettes a day)

Interventions

DRUGGnRHa

Gonadotropin-releasing hormone analogue, intramuscular injection of 3.75mg will be given every 4 weeks , and the maximum using courses will be 6.

DRUGLetrozole 2.5mg

2.5mg po qd and no more than 24 weeks

DRUGDiane-35

Periodic use. Patients will receive one pill po qd for 21 days, and next period should be started after 7 days.

DRUGMET

500mg po tid


Locations(2)

Obstetrics and Gynecology Hospital, Fudan University

Shanghai, Shanghai Municipality, China

Tenth People's Hospital of Tongji University

Shanghai, Shanghai Municipality, China

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NCT05316935


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