Progesterone-like hormones that can reverse early endometrial cancer in women who want to keep their uterus, and control advanced hormone-sensitive disease.
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.
Progesterone receptor agonism suppresses ER-driven proliferation and induces glandular differentiation of endometrial epithelium. Connects to Estrogen receptor (ERα).
1.Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD) acts on Estrogen receptor (ERα), the hormone receptor or the enzyme that makes the hormone.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Megestrol and medroxyprogesterone are generic Part D drugs. The levonorgestrel IUD is placed by a clinician and billed under Part B, and is a $0 preventive benefit in most commercial plans under the ACA when used for contraception.
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE search: progestins. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Region | Year | Indication |
|---|---|---|
| US | 1971 | Palliative treatment of advanced endometrial and breast cancer (megestrol) |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Weight gain | 30% | - |
| Venous thromboembolism | - | - |
Increased risk with high-dose oral progestins. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"Progestins" OR ABSTRACT:"Progestins" OR TITLE:"megestrol acetate, medroxyprogesterone, levonorgestrel IUD" OR ABSTRACT:"megestrol acetate, medroxyprogesterone, levonorgestrel IUD" OR TITLE:"Megace; Mirena" OR ABSTRACT:"Megace; Mirena" OR TITLE:"Levonorgestrel" OR ABSTRACT:"Levonorgestrel" OR TITLE:"Levonorgestrel intrauterine device" OR ABSTRACT:"Levonorgestrel intrauterine device" OR TITLE:"Megestrol acetate" OR ABSTRACT:"Megestrol acetate") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD), not a curated reading list.
Shares Progesterone receptor (PGR), Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine, Endocrine therapy (SERMs, AIs, SERDs), Endometrial cancer.
Shares Treatment With Medroxyprogesterone Acetate Plus LNG-IUS in Young Women With Early Stage Endometrial Cancer, Endometrial cancer.
Shares Endometrial cancer with no specific molecular profile, Advanced or recurrent endometrial cancer, Endometrial cancer.
Shares Molecular-class-directed adjuvant therapy in endometrial cancer, Endometrial cancer with no specific molecular profile, Endometrial cancer.
Shares Endometrial cancer with no specific molecular profile, Uterine sarcoma, Endometrial cancer.
Shares Molecular-class-directed adjuvant therapy in endometrial cancer, Advanced or recurrent endometrial cancer.
Shares Endometrial cancer with no specific molecular profile, Advanced or recurrent endometrial cancer, Endometrial cancer.
Shares Endometrial cancer with no specific molecular profile, Advanced or recurrent endometrial cancer.