{"entity":{"id":"megestrol-progestins","kind":"drug","name":"Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD)","aka":["Levonorgestrel","Levonorgestrel intrauterine device","Megestrol acetate","Medroxyprogesterone","Oral progestins"],"tldr":"Progesterone-like hormones that can reverse early endometrial cancer in women who want to keep their uterus, and control advanced hormone-sensitive disease.","summary":"Fertility-sparing therapy for grade 1, stage IA endometrioid cancer or atypical hyperplasia (oral progestin or levonorgestrel IUD; complete response ~70-80% within 12 months, relapse ~30%). In advanced ER/PR-positive low-grade disease, progestins, alternating with tamoxifen (GOG-119), or aromatase inhibitors with CDK4/6 inhibitors (PALEO, NRG-GY019) give durable control with minimal toxicity.","status":"approved","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Megestrol_acetate","links":[{"label":"FDA label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Progestins"}],"tags":[],"related":[],"cancers":["endometrial"],"sections":[],"technologies":["endocrine-therapy"],"targets":["estrogen-receptor"],"drugs":[],"companies":[],"institutions":[],"pathways":["er-signaling"],"terms":[],"trials":["nct03463252","nct02990728","nct01594879"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Megace; Mirena (IUD)","modality":"Hormonal therapy (progestin)","mechanism":"Progesterone receptor agonism suppresses ER-driven proliferation and induces glandular differentiation of endometrial epithelium.","approvals":[{"region":"US","year":1971,"indication":"Palliative treatment of advanced endometrial and breast cancer (megestrol)"}],"mechanismSteps":[],"dosing":{"route":"Oral or intrauterine","schedule":"Megestrol 160 mg daily; levonorgestrel 52 mg IUD; re-biopsy every 3-6 months in fertility-sparing use","monitoring":"Endometrial sampling, weight, thrombosis risk"},"toxicity":[{"event":"Weight gain","anyGradePct":30},{"event":"Venous thromboembolism","note":"Increased risk with high-dose oral progestins"}],"access":[],"regulatoryEvents":[]},"route":"/drugs/megestrol-progestins/","neighbours":{"cancer":[{"id":"advanced-recurrent-endometrial-cancer","kind":"cancer","name":"Advanced or recurrent endometrial cancer","route":"/cancers/advanced-recurrent-endometrial-cancer/"},{"id":"endometrial","kind":"cancer","name":"Endometrial cancer","route":"/cancers/endometrial/"},{"id":"endometrial-nsmp","kind":"cancer","name":"Endometrial cancer with no specific molecular profile","route":"/cancers/endometrial-nsmp/"},{"id":"uterine-sarcoma","kind":"cancer","name":"Uterine sarcoma","route":"/cancers/uterine-sarcoma/"}],"technology":[{"id":"cachexia-appetite-pharmacotherapy","kind":"technology","name":"Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine","route":"/technologies/cachexia-appetite-pharmacotherapy/"},{"id":"endocrine-therapy","kind":"technology","name":"Endocrine therapy (SERMs, AIs, SERDs)","route":"/technologies/endocrine-therapy/"},{"id":"fertility-sparing-endometrial","kind":"technology","name":"Fertility-sparing hormonal treatment of early endometrial cancer","route":"/technologies/fertility-sparing-endometrial/"}],"target":[{"id":"estrogen-receptor","kind":"target","name":"Estrogen receptor (ERα)","route":"/targets/estrogen-receptor/"},{"id":"pgr","kind":"target","name":"Progesterone receptor (PGR)","route":"/targets/pgr/"}],"pathway":[{"id":"er-signaling","kind":"pathway","name":"Oestrogen receptor signalling","route":"/pathways/er-signaling/"}],"trial":[{"id":"nct06998758","kind":"trial","name":"Megestrol Acetate in Improving Neoadjuvant Chemotherapy-Related Weight Loss in Locally Advanced CRC","route":"/trials/nct06998758/"},{"id":"nct02990728","kind":"trial","name":"Mirena® ± Metformin as Fertility-preserving Treatment for Young Asian Women With Early Endometrial Cancer","route":"/trials/nct02990728/"},{"id":"nct01594879","kind":"trial","name":"Treatment With Medroxyprogesterone Acetate Plus LNG-IUS in Young Women With Early Stage Endometrial Cancer","route":"/trials/nct01594879/"},{"id":"nct03463252","kind":"trial","name":"Value of LNG-IUS as Fertility-preserving Treatment of EAH and EC","route":"/trials/nct03463252/"}],"idea":[{"id":"idea-molecular-class-adjuvant-endometrial","kind":"idea","name":"Molecular-class-directed adjuvant therapy in endometrial cancer","route":"/ideas/idea-molecular-class-adjuvant-endometrial/"}]}}