ideasIdea
GLP-1 drugs to reverse endometrial precancer in women with obesity
Womb precancer in women with obesity is usually treated with a hormone coil or hysterectomy. Weight-loss drugs might reverse it and protect fertility.
Atypical endometrial hyperplasia progresses to cancer in roughly 30% of cases and obesity is the driver. Propose an RCT of GLP-1 receptor agonist plus levonorgestrel intrauterine system versus the intrauterine system alone, with histological regression at six months as the endpoint.
Hypothesis
Adding a GLP-1 receptor agonist increases complete regression from about 70% to at least 85% and halves relapse at two years.
Rationale
Weight loss after bariatric surgery reverses hyperplasia; GLP-1 offers a non-surgical route.
What would test it
300-woman RCT.
Maturity
early clinical
Who has to act
research
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.