Orlistat added to progestin for uterus-sparing treatment of early endometrial cancer
Tests adding orlistat to progestin in women with early endometrial cancer or atypical hyperplasia.
Plain-language title generated from the registry record
Registry title: Orlistat Plus Progestin for Fertility-Sparing Treatment of Endometrial Cancer or Atypical Hyperplasia
Key facts
- Where
- Beijing, ChinaSee the site
- Phase
- Phase 2
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for women aged 45 or younger who want to keep their fertility. They have early endometrial cancer (grade 1-2) or atypical endometrial hyperplasia that did not clear after at least 3 months of progestin, with a low progesterone receptor level.
- Age
- 45 years or younger.
- Sex
- Women only.
- Disease stage
- Grade 1-2 endometrioid endometrial cancer or atypical endometrial hyperplasia, confined to the endometrium (FIGO 2009 stage IA, no myometrial invasion; for G1, superficial invasion less than one half is allowed). The disease must still be present after first-line progestin.
- Earlier treatment
- At least 3 months of first-line MPA 250-500 mg/day or MA 160-320 mg/day, with a check (hysteroscopy plus curettage) showing the disease did not fully clear. No orlistat or other lipase inhibitors in the past 6 months.
- Biomarker or test result
- Progesterone receptor (PR): 25% or less PR-positive cells and staining intensity grade 1 or lower. Body mass index (BMI) 24 kg/m2 or higher.
Main reasons for not taking part
- Cancer growing into more than one half of the uterine muscle wall, or FIGO (2009) stage IB or higher
- Grade G3 or non-endometrioid cancer types (serous, clear cell, carcinosarcoma, etc.)
- Another reproductive-system cancer, or a hormone-dependent cancer such as breast cancer that rules out progestin
- Pregnancy or breastfeeding
- Allergy to orlistat, chronic malabsorption or cholestasis, or use of certain interacting drugs (ciclosporin, warfarin, levothyroxine, carbamazepine, phenytoin, amiodarone)
Read by machine on 13 November 2026.
Where in China
- Peking University People's HospitalBeijing, ChinaContact: Jian liu W, MDNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- Peking University People's Hospital
- Trial code
- NCT07714070
- Record updated
- 20 July 2026
- Original description
This is a single-center, randomized, open-label, controlled clinical trial evaluating whether adding orlistat to standard progestin therapy can improve treatment response in patients receiving fertility-sparing treatment for early-stage endometrial cancer (grade 1-2) or atypical endometrial hyperplasia.Read full original descriptionShow less
A Single-Center, Randomized, Open-Label, Controlled Trial of Orlistat Combined With Progestin for Fertility-Sparing Treatment of Endometrial Cancer or Atypical Endometrial Hyperplasia With Low Progesterone Receptor Expression
This is a single-center, randomized, open-label, controlled clinical trial evaluating whether adding orlistat to standard progestin therapy can improve treatment response in patients receiving fertility-sparing treatment for early-stage endometrial cancer (grade 1-2) or atypical endometrial hyperplasia.
Progestin is the standard drug used to preserve the uterus and fertility in these patients, but about 30% of patients respond poorly because the progesterone receptor (PR) in the endometrium is lost or reduced. Laboratory studies by the research team have shown that orlistat, a widely used oral weight-loss drug that blocks fat absorption, can raise PR levels and restore sensitivity to progestin.
The study will enroll 48 patients (age 45 years or younger, body mass index 24 kg/m2 or higher) who still have residual disease and low PR expression after at least 3 months of first-line progestin therapy. Participants will be randomly assigned in a 1:1 ratio to receive either progestin plus orlistat (experimental group) or progestin alone (control group) for 3 months, followed by 24 months of follow-up. The main goal is to compare the change in PR expression from baseline after 3 months of treatment. The study will also assess how many patients achieve complete disease reversal, time to complete response, recurrence, pregnancy and live-birth rates, safety, and changes in body weight and metabolic measures.
Inclusion: Histologically confirmed grade 1-2 endometrioid endometrial adenocarcinoma or atypical endometrial hyperplasia (AEH), independently confirmed by two senior pathologists; Lesion confined to the endometrium on MRI or transvaginal ultrasound; FIGO (2009) stage IA without myometrial invasion (for G1, superficial invasion less than one half is allowed; G2 must have no myometrial invasion); Age 45 years or younger; Received first-line MPA 250-500 mg/day or MA 160-320 mg/day for at least 3 months, with hysteroscopy plus curettage confirming failure to achieve complete response (persistent EC/AEH lesion); PR-positive cell percentage 25% or less and intensity grade 1 or lower (0 negative, 1 weak, 2 moderate, 3 strong), independently judged by two senior pathologists with a third adjudicating any disagreement; BMI 24 kg/m2 or higher; no severe comorbidity, specifically ALT/AST 2.5x ULN or lower, serum creatinine 1.5x ULN or lower, and no history of active gastrointestinal bleeding; No contraindication to progestin therapy or to pregnancy; No evidence of distant metastasis on pelvic MRI and chest/abdominal CT; Clearly wishes to preserve fertility and provides signed informed consent; No use of orlistat or other lipase inhibitors within the past 6 months; Willing and able to comply with follow-up at this hospital.
Exclusion: Allergy to orlistat or any formulation component, or prior severe adverse reaction (including severe hepatic injury) to orlistat; Concurrent use of ciclosporin, warfarin, levothyroxine, antiepileptics (carbamazepine, phenytoin), or amiodarone that interact significantly with orlistat and cannot be replaced or dose-adjusted; Planned bariatric surgery (gastric bypass, sleeve gastrectomy, etc.) during the study; Coexisting other endometrial cancer or other reproductive-system malignancy; coexisting breast cancer or other hormone-dependent tumor precluding progestin use; Chronic malabsorption syndrome (Crohn disease, celiac disease, short bowel syndrome) or cholestasis; Tumor invading more than one half of the myometrium; FIGO (2009) stage IB or higher; Grade G3 or non-endometrioid histology (serous, clear cell, carcinosarcoma, etc.); Pregnancy or lactation; unwilling to use reliable contraception during the study and for 3 months after study completion; Poor compliance or unable to complete 24 months of follow-up.