# Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD)

Source: https://onco.cc/drugs/megestrol-progestins/  
OnCo record `megestrol-progestins` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Also known as: Levonorgestrel; Levonorgestrel intrauterine device; Megestrol acetate; Medroxyprogesterone; Oral progestins
- Brand: Megace; Mirena (IUD)
- Modality: Hormonal therapy (progestin)
- Mechanism: Progesterone receptor agonism suppresses ER-driven proliferation and induces glandular differentiation of endometrial epithelium.
- Approvals: US 1971: Palliative treatment of advanced endometrial and breast cancer (megestrol)
- Dosing: Oral or intrauterine; Megestrol 160 mg daily; levonorgestrel 52 mg IUD; re-biopsy every 3-6 months in fertility-sparing use

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Megestrol_acetate
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Progestins

## Connected records

- cancers: [Advanced or recurrent endometrial cancer](https://onco.cc/cancers/advanced-recurrent-endometrial-cancer/), [Endometrial cancer](https://onco.cc/cancers/endometrial/), [Endometrial cancer with no specific molecular profile](https://onco.cc/cancers/endometrial-nsmp/), [Uterine sarcoma](https://onco.cc/cancers/uterine-sarcoma/)
- technologies: [Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine](https://onco.cc/technologies/cachexia-appetite-pharmacotherapy/), [Endocrine therapy (SERMs, AIs, SERDs)](https://onco.cc/technologies/endocrine-therapy/), [Fertility-sparing hormonal treatment of early endometrial cancer](https://onco.cc/technologies/fertility-sparing-endometrial/)
- targets: [Estrogen receptor (ERα)](https://onco.cc/targets/estrogen-receptor/), [Progesterone receptor (PGR)](https://onco.cc/targets/pgr/)
- pathways: [Oestrogen receptor signalling](https://onco.cc/pathways/er-signaling/)
- trials: [Megestrol Acetate in Improving Neoadjuvant Chemotherapy-Related Weight Loss in Locally Advanced CRC](https://onco.cc/trials/nct06998758/), [Mirena® ± Metformin as Fertility-preserving Treatment for Young Asian Women With Early Endometrial Cancer](https://onco.cc/trials/nct02990728/), [Treatment With Medroxyprogesterone Acetate Plus LNG-IUS in Young Women With Early Stage Endometrial Cancer](https://onco.cc/trials/nct01594879/), [Value of LNG-IUS as Fertility-preserving Treatment of EAH and EC](https://onco.cc/trials/nct03463252/)
- ideas: [Molecular-class-directed adjuvant therapy in endometrial cancer](https://onco.cc/ideas/idea-molecular-class-adjuvant-endometrial/)

---
JSON: https://onco.cc/api/v1/entities/megestrol-progestins.json