Megestrol Acetate Plus Metformin to Megestrol Acetate in Patients With Endometrial Atypical Hyperplasia or Early Stage Endometrial Adenocarcinoma
Conditions
Endometrial Atypical Hyperplasia - Endometrial Adenocarcinoma
Conditions: official terms
Adenocarcinoma - Hyperplasia - Uterine Neoplasms
Conditions: Keywords
Endometrial Atypical Hyperplasia, Endometrial Adenocarcinoma, Conservative Medication
Study Type
Interventional
Study Phase
Phase 2
Study Design
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Intervention
Name: Megestrol acetate and metformin Type: Drug
Name: Megestrol acetate Type: Drug
Overall Status
Recruiting
Summary
The purpose of this study is to see if megestrol acetate plus metformin will be more effective in returning the endometrial tissue to a normal state than megestrol acetate alone in patients with endometrial atypical hyperplasia or early stage endometrial adenocarcinoma.
Detailed Description
After diagnosed of endometrial atypical hyperplasia(EAH) or type I endometrial cancer(EC) by dilatation and curettage (D&C) or hysteroscopy, patients will be enrolled. Age, waist circumstances, blood pressure, basic history of infertility, blood pressure, serum lipid level and side effects will be collected. Blood tests, including triglycerides, high density lipoprotein-cholesterol, fasting blood glucose, liver and kidney function will be performed before treatment to evacuate their metabolic conditions.

Patients are randomized to 1 of 2 treatment groups. Patients will receive metformin 500 mg by mouth third daily and megestrol acetate 150 mg by mouth daily for 3 months on Arm I. Patients will receive megestrol acetate 150 mg PO daily for 3 months on Arm II. Then an hysteroscope will be used to evaluate the endometrial condition, and the findings will be recorded. For patients with EAH, complete response (CR) is defined as the reversion of endometrial atypical hyperplasia to proliferative or secretory endometrium; partial response (PR) is defined as regression to simple or complex hyperplasia without atypia; no response (NR) is defined as the persistence of the disease; and progressive disease (PD) is defined as the appearance of endometrial cancer in patients. EAH after treatment will be defined as PR in patients with EC. Continuous therapies will be needed in PR, NR or PD.

After completion of study treatment, 3 months of maintenance treatment will be recommended for patients with CR, and they will be followed up for 2 years.

In addition, we've already had a pilot study in 19 patients primarily diagnosed of endometrial atypical hyperplasia from August 2012 to April 2013. 10 patients were in Arm I and 9 patients were in Arm II. Metabolic syndrome were evaluated among all subjects. After treatment, megestrol acetate plus metformin worked better than megestrol acetate alone. But two arms showed no difference in NR patients, which may suggest metformin just worked as an antitumor drug more than an insulin sensitizer. More supportive researches are needed to verify it.
Criteria for eligibility
Healthy Volunteers: No
Maximum Age: 45 Years
Minimum Age: 18 Years
Gender: Female
Criteria: Inclusion Criteria:

- Be between the ages of 18-45 years old

- Primarily have a confirmed diagnosis of endometrial atypical hyperplasia based upon D&C or hysteroscopy

- OR primarily have a confirmed diagnosis of endometrial adenocarcinoma(G1, low tumor grade), based upon D&C or hysteroscopy, and three MRI parameters shows there's no myometrial invasion, extension beyond corpus, or enlarged lymph nodes

- Have a desire for remaining reproductive function or uterus

- Need to be able to undergo correlative treatment and follow-up

Exclusion Criteria:

- Have a history of serious liver or renal dysfunction

- Have a confirmed diagnosis of malignant tumor in genital system

- Have taken oral contraceptive or other medicine for the treatment of endometrial hyperplasia in the past 6 months

- Ask for removal of the uterus or other conservative treatment

- serum CA-125 > 35 Um/L
Locations
Fudan University Shanghai Cancer Center
Shanghai, Shanghai, China
Status: Recruiting
Contact: Huaying Wang, PhD - huaying_wang@yahoo.com
Obstetrics and Gynecology Hospital, Fudan University
Shanghai, Shanghai, China
Status: Recruiting
Contact: Xiaojun Chen, PhD - 862163455055 - cxjlhjj@163.com
Shanghai Changning Maternity & Infant Health Hospital
Shanghai, Shanghai, China
Status: Recruiting
Contact: Chengbin Ma - machenbin@sohu.com
Shanghai Sixth People's Hospital
Shanghai, Shanghai, China
Status: Recruiting
Contact: Yincheng Teng
Zhejiang Cancer Hospital
Hangzhou, Zhejiang, China
Status: Recruiting
Contact: Jianqing Zhu - +86-0571-88122222
Start Date
October 2013
Sponsors
Xiaojun Chen
Source
Fudan University
Record processing date
ClinicalTrials.gov processed this data on July 28, 2015
ClinicalTrials.gov page