- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05332483
Study of Megestrol Acetate in Grade 2 Endometrioid Endometrial Cancer (MA-EEC)
The Effect of Megestrol Acetate on Grade 2 Endometrioid Endometrial Cancer in Patients Waiting for Definitive Surgery, a Prospective Trial
Study Overview
Detailed Description
The incidence of endometrial cancer is increasing due to the rising rates of obesity. Further, the average age at onset is decreasing. As a result, there is a growing interest in fertility-sparing treatments, such as progesterone-based therapy. While the role of progestins for the conservative management of atypical hyperplasia and with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) grade 1 endometrial endometrioid carcinomas (EEC), assigned on preoperative endometrial biopsy, is well established, there is limited clinical experience in patients FIGO grade 2 EECs (EEC2) for whom the current standard therapy is hysterectomy. However, there are case reports of successful progestin treatment of patients with preoperative biopsy EEC2, suggesting that progestin response mechanisms are functional in select EEC2s and that hormonal treatment may be a viable option if the responsive patients could be safely identified.
In this study, the investigators will prospectively recruit EEC2 patients for pre-operative progestin treatment. Participants will be given high-dose progestin from day of consent for a minimum of 21 days. This will allow investigators to generate a unique cohort of matched pre-progestin treatment biopsies and post-treatment surgical specimens for each participant. The investigators intend to analyze clinical, pathological and transcriptomic data of EEC2 that histologically respond to progestin therapy versus their counterparts that do not, with the goal of identifying candidate predictive biomarkers and clinical parameters that would supplement pathological screening of these lesions to better stratify patient classification to good and poor responders. Once good responders are successfully characterize, this will enable the investigators to identify patients with biopsy EEC2 that could be safely managed conservatively with oral progestin therapy. For young patients, who have not completed their family planning, this could mean the difference between undergoing a hysterectomy versus retaining their fertility.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Contact
- Name: Bojana Djordjevic, MD
- Phone Number: (416) 480-6100 x5709
- Email: bojana.djordjevic@sunnybrook.ca
Study Locations
-
-
Ontario
-
Toronto, Ontario, Canada, M4N 3M5
- Sunnybrook Health Sciences
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult female patient 18 years of age or older.
- Confirmed diagnosis of FIGO grade 2 endometrioid endometrial cancer on preoperative endometrial biopsy read by a pathologist with a subspecialty in gynecologic pathology.
- Stage 1 endometrioid endometrial cancer on preoperative endometrial biopsy.
- P53 wild type immunohistochemistry on preoperative endometrial biopsy.
- Patients eligible for primary staging surgery for definitive treatment for their cancer.
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Required Initial Laboratory Values obtained within 3 days of enrolment following standard of care protocols: Absolute Neutrophil Count (ANC) ≥ 1,500/mm3; Platelet Count ≥ 100,000/mm3; eGFR ≥ 60 mL/min/1.73m2; Total Bilirubin ≤ 1.5 x upper limit of normal (ULN); AST / ALT ≤ 2.5 x upper limit of normal (ULN).
- Informed consent for this study is obtained and signed by the participant or have an acceptable Substitute Decision Maker (SDM) capable of signing the informed consent form on behalf of the participant.
Exclusion Criteria:
- Patients cannot be receiving systemic or hormonal therapy for treatment of the endometrial cancer.
- Prior radiation therapy for treatment of the endometrial cancer is not allowed.
- Stage 2 or 3 endometrioid endometrial cancer on preoperative endometrial biopsy.
- Abnormal p53 immunohistochemistry on preoperative endometrial biopsy.
- History of an allergic reaction to medroxyprogesterone acetate.
- History of venous thromboembolic event (including previous deep vein thrombosis or pulmonary embolism).
- Family history of venous thromboembolic event.
- Have a >20 pack-year smoking history.
- Patients unwilling or unable to follow the study protocol schedule.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm 1 - Megestrol
All study participants will receive Megestrol acetate, 160 mg daily (two 40mg tablets twice a day), for a minimum of 18 days.
|
Megestrol acetate, 160 mg daily (two 40mg tablets twice a day), for a minimum of 18 days.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall response rate of patients with biopsy grade 2 endometrioid endometrial cancer treated preoperatively with Megestrol acetate for a minimum of 21 days.
Time Frame: 2 years
|
Tumor response will be strictly histologically defined. Surgical specimens of each patient will be grossed in the pathology department as per standard of care. The degree of tumor response will be defined as follows:
|
2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Correlations between response to progestin and clinical, histological and transcriptomic pre-operative biomarkers that may impact therapy planning.
Time Frame: 3 years
|
The secondary outcome answers whether there is a pre-treatment biomarker signature at baseline biopsy that can predict therapeutic response to progestin among grade 2 endometrioid endometrial cancer patients.
To identify molecular correlates of treatment response transcriptional profiling of pre-treatment and post-treatment tissue specimens will be performed.
|
3 years
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Bojana Djordjevic, MD, SunnyBrook Health Sciences Centre
- Principal Investigator: Danielle Vicus, MD, MSc, SunnyBrook Health Sciences Centre
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Uterine Neoplasms
- Genital Neoplasms, Female
- Uterine Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Genital Diseases
- Genital Diseases, Female
- Endometrial Neoplasms
- Physiological Effects of Drugs
- Antineoplastic Agents
- Antineoplastic Agents, Hormonal
- Contraceptive Agents, Hormonal
- Contraceptive Agents
- Reproductive Control Agents
- Contraceptives, Oral
- Contraceptive Agents, Female
- Contraceptives, Oral, Synthetic
- Contraceptives, Oral, Hormonal
- Central Nervous System Stimulants
- Appetite Stimulants
- Megestrol
- Megestrol Acetate
Other Study ID Numbers
- 4858
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Endometrial Cancer
-
Assistance Publique - Hôpitaux de ParisUniversité Montpellier; Ecole d'econmie de Paris (PSE)-Hospinnomics; Université...CompletedEndometrial Cancer Stage I | Endometrial Cancer Stage IIFrance
-
Radboud University Medical CenterMaastricht University Medical Center; Erasmus Medical Center; Catharina Ziekenhuis... and other collaboratorsRecruitingEndometrial Cancer Recurrent | Endometrial Cancer Stage III | Endometrial Cancer Stage IVNetherlands
-
Batman Training and Research HospitalEskisehir Osmangazi UniversityCompletedGynecologic Cancer | Endometrial Cancer Stage
-
Chia Tai Tianqing Pharmaceutical Group Co., Ltd.RecruitingAdvanced Endometrial CancerChina
-
Novartis PharmaceuticalsCompletedAdvanced Endometrial CancerBelgium, France, Italy, Canada, Spain, Australia, Germany, United States, Japan, Brazil, Singapore, Russian Federation, Poland
-
Samsung Medical CenterRecruitingEndometrial Cancer Stage IKorea, Republic of
-
Duke UniversityDuke Cancer InstituteCompleted
-
Far Eastern Memorial HospitalCompletedOutcome of Endometrial CancerTaiwan
-
Rambam Health Care CampusCompletedSerous Papillary Endometrial CancerIsrael
-
Masonic Cancer Center, University of MinnesotaCompletedCervical Cancer | Ovarian Cancer | Uterine Endometrial CancerUnited States
Clinical Trials on Megestrol Acetate
-
Southwest Oncology GroupNational Cancer Institute (NCI)CompletedBreast Cancer | Hot Flashes
-
Xiaojun ChenZhejiang Cancer Hospital; Fudan University; Shanghai 6th People's Hospital; Shanghai...CompletedEndometrial Adenocarcinoma | Endometrial Atypical HyperplasiaChina
-
Par Pharmaceutical, Inc.PRA Health SciencesTerminatedAnorexia | Weight Loss | CachexiaUnited States
-
Bristol-Myers SquibbCompletedHIV Infections | Anorexia | CachexiaUnited States
-
Bristol-Myers SquibbCompletedHIV Infections | Anorexia | CachexiaUnited States
-
Endo PharmaceuticalsQuintiles, Inc.CompletedHIV Infections | Anorexia | Cachexia | HIV Wasting Syndrome | AIDS Wasting SyndromeUnited States, India, South Africa
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)CompletedAnorexia | Lung Cancer | CachexiaUnited States
-
Bristol-Myers SquibbCompletedHIV Infections | Anorexia | CachexiaUnited States
-
St. Vincent Medical Center - Los AngelesUnknownBreast Cancer | Malignant Mesothelioma | Endometrial CancerUnited States
-
Northwestern UniversityNational Cancer Institute (NCI)CompletedFatigue | Unspecified Adult Solid Tumor, Protocol Specific | CachexiaUnited States