ClinicalTrials.gg
RecruitingNCT06073184WE-FiERCEUpdated Oct 5, 2026

Weight-loss Drug for Fertility-Sparing Treatment of Atypical Hyperplasia and Low-grade Cancer of the Endometrium

A Phase 2 interventional study of Wegovy and Mirena in Endometrial Cancer, Atypical Hyperplasia and Fertility Perservation, sponsored by GynOncTrials. Recruiting at 1 site in Canada. Open to female participants aged 18 Years to 41 Years. Per ClinicalTrials.gov, last updated 2026-10-05.

Sponsored by GynOncTrials · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2026; still recruiting 1 month later.
Updated Oct 5, 2026Now RecruitingFirst site in Canada+7 moreGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
71
Allocation
Not applicable
Ages
18 Years to 41 Years
Sex
Female
01

Study summary

The incidence of endometrial cancer is increasing at an alarming rate. This trend parallels the rising rate of obesity, the most significant risk factor for endometrial cancer. Young women with obesity and endometrial cancer or atypical hyperplasia who want to maintain their fertility are treated with progestin therapy, such as progestin intra-uterine device (pIUD), which is associated with a mediocre response rate and high recurrence rate, and does not address the underlying cause, obesity. Therefore, the investigators want to assess whether the addition of a weight-loss drug to pIUD will improve their oncologic, reproductive and metabolic outcomes.

Read the detailed description

The research aims to answer the question: "Does the addition of a Glucagon-like Peptide-1 (GLP-1) to standard progestin treatment lead to a higher complete response rate compared to historical response rates using progestin alone in young patients with endometrial cancer/atypical hyperplasia who wish to preserve their fertility?".

This is a multicentre single arm open-label phase II clinical trial to assess the complete pathologic response as determined by endometrial sampling after 48 weeks of semaglutide (GLP-1) and progestin therapy in patients with BMI ≥ 27 who have endometrial cancer/atypical hyperplasia and desire fertility preservation.

02

Conditions studied

  • Endometrial Cancer
  • Atypical Hyperplasia
  • Fertility Perservation

Keywords

  • pIUD
  • semaglutide
  • WEGOVY
  • atypical hyperplasia
  • endometrial cancer
  • fertility preservation
03

In context

Endometrial Neoplasms

1,425 studies on the registry are indexed under Endometrial Neoplasms; 473 are open to participants now.

This study's planned enrollment of 71 is close to the median of 71 across 1,026 interventional studies indexed under Endometrial Neoplasms.

Browse Endometrial Neoplasms studies →

Lead sponsor

This is the only study on the registry with GynOncTrials as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Oct 5, 2026. See what changed

Ages eligible
18 Years to 41 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • ≥ 27
  • Diagnosis of grade 1 endometrioid endometrial cancer or atypical hyperplasia made by either endometrial or dilation and curettage
  • For those with endometrial cancer, clinical FIGO 2009 stage 1A disease without evidence of disease beyond the uterus and no myometrial invasion by MRI or CT
  • status \<2
  • Desire for fertility preservation
  • Ability to understand and willing to sign a written document

Exclusion criteria

Exclusion Criteria:

  • Evidence of myometrial invasion or extra-uterine disease on imaging
  • High grade or p53 mutated (p53mut) endometrial cancer
  • Estrogen receptor negative endometrial cancer (positivity defined as moderate/strong staining>10%)
  • Mismatch repair deficient (MMRd) endometrial cancer
  • History of other except if curatively treated with no evidence of disease for >5 years
  • Previous surgical treatment of obesity
  • Current use of weight loss medication (no use in last 2 months)
  • Medical comorbidity with end-organ dysfunction
  • History of suicide attempts or current suicidal thoughts or behaviours
  • Currently taking insulin or insulin secretagogue (e.g., sulfonylurea)
  • Diabetic retinopathy
  • Gastroparesis or problems with food digestion
  • History of tachycardia (e.g., sinus tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter, or ventricular tachycardia)
  • to pIUD or semaglutide.

    • Hypersensitive to WEGOVY or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container
    • Personal or family history of medullary thyroid carcinoma (MTC)
    • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
    • Pregnant or breast-feeding
    • Current or recurrent pelvic inflammatory disease
    • Lower genital tract infection
    • Postpartum endometritis
    • Uterine anomalies including fibroids if they distort the uterine cavity
    • Cervical malignancy
    • Known or suspected progestin-dependent neoplasia, including breast cancer
    • Cervicitis
    • Untreated cervical dysplasia
    • Active liver disease or dysfunction
    • Actual benign or malignant liver tumors
    • Sceptic abortion within the previous three months
    • to levonorgestrel or any of the other ingredients in the formulation or components of MIRENA.
    • Bacterial endocarditis
    • Established immunodeficiency
    • Acute malignancies affecting blood or leukemias
    • Recent trophoblastic disease while hCG levels are elevated
    • Previously inserted intrauterine device (IUD) that has not been removed
    • Conditions associated with increased susceptibility to pelvic infections
  • Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures.
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
71 participants (estimated)

Study arms

  • Experimental
    Semaglutide and Progestin Intrauterine Device

    All patients will receive a progestin intrauterine device and semaglutide subcutaneous injections

    Drug: Wegovy · Drug: Mirena

Interventions

  • DrugWegovy

    Weekly subcutaneous injection of 0.25 mg semaglutide at baseline with dose escalation every 4 weeks to reach 2.4 mg or the maximum tolerated dose, by Week 16

    Also known as: Semaglutide

  • DrugMirena

    Levonorgestrel-releasing Intrauterine System (52mg) to deliver up to 20 mcg levonorgestrel per day

    Also known as: Progestin-releasing intra-uterine device (pIUD)

06

What researchers measure

Primary outcomes

  1. Assessment of Complete Pathologic Response

    Proportion of patients (%) who achieve pathological complete response at 48 weeks after initiation of pIUD and semaglutide.

    Time frame: 48 weeks

Secondary outcomes

  1. Assessment of Safety and Tolerability

    Adverse events during treatment period

    Time frame: 48 weeks

  2. Assessment of Feasibility

    Rate of accrual; patient compliance; retention

    Time frame: 1.5 years

  3. Assessment of Secondary Oncologic Outcomes

    Time to achieve complete response; duration of response; recurrence rate; time to recurrence; progression/persistence rate

    Time frame: 6 years

  4. Assessment of Reproductive Outcomes

    Rate of pregnancy; live birth; miscarriage; pregnancy complications

    Time frame: 6 years

  5. Assessment of Patient Reported Outcomes

    Quality of life; psychological functioning and fertility concerns after cancer diagnosis

    Time frame: 48 weeks

  6. Assessment of Metabolic Outcomes

    Weight; BMI; waist/hip circumference; serum biomarkers of obesity and insulin resistance

    Time frame: 48 weeks

07

Study locations

1 of 1 sites recruiting
08

Updates

1 registry update since Sep 25, 2026
Status
Not yet recruiting→Recruiting
changed Oct 5, 2026
Sites
1 site added — first site in Canada
Show site
  • Princess Margaret Cancer Centre, University Health Network · Toronto, Canada
Oct 5, 2026
Start date
Aug 2025→Sep 17, 2026 (actual)
Oct 5, 2026
Primary completion
Feb 2027→Feb 2029
Oct 5, 2026
Eligibility
1 inclusion criterion edited; 2 exclusion criteria edited, 27 added
What changed in the criteria
Inclusion criteria
  • EditedDiagnosis of grade 1 or 2 endometrioid endometrial cancer or atypical hyperplasia made by either endometrial biopsy or dilation and curettage
Exclusion criteria
  • EditedMedical co-morbiditycomorbidity with end-organ dysfunction
  • AddedHistory of suicide attempts or current suicidal thoughts or behaviours
  • AddedCurrently taking insulin or insulin secretagogue (e.g., sulfonylurea)
  • AddedDiabetic retinopathy
  • AddedGastroparesis or problems with food digestion
  • AddedHistory of tachycardia (e.g., sinus tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter, or ventricular tachycardia)
  • EditedContraindications to pIUD or tirzepatidesemaglutide.
  • AddedHypersensitive to WEGOVY or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container
  • AddedPersonal or family history of medullary thyroid carcinoma (MTC)
  • AddedMultiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • AddedPregnant or breast-feeding
  • AddedCurrent or recurrent pelvic inflammatory disease
  • AddedLower genital tract infection
  • AddedPostpartum endometritis
  • AddedUterine anomalies including fibroids if they distort the uterine cavity
  • AddedCervical malignancy
  • AddedKnown or suspected progestin-dependent neoplasia, including breast cancer
  • AddedCervicitis
  • AddedUntreated cervical dysplasia
  • AddedActive liver disease or dysfunction
  • AddedActual benign or malignant liver tumors
  • AddedSceptic abortion within the previous three months
  • AddedHypersensitivity to levonorgestrel or any of the other ingredients in the formulation or components of MIRENA.
  • AddedBacterial endocarditis
  • AddedEstablished immunodeficiency
  • AddedAcute malignancies affecting blood or leukemias
  • AddedRecent trophoblastic disease while hCG levels are elevated
  • AddedPreviously inserted intrauterine device (IUD) that has not been removed
  • AddedConditions associated with increased susceptibility to pelvic infections
Oct 5, 2026
Interventions
Added Drug: Wegovy; removed Drug: Mounjaro. Arm changed Tirzepatide and Progestin Intrauterine Device→Semaglutide and Progestin Intrauterine Device
Oct 5, 2026
Primary outcomes
1 description edited
What changed in the outcomes
  • DescriptionAssessment of Complete Pathologic Response: how it is measured was reworded
Oct 5, 2026
Secondary outcomes
1 time frame changed, 5 description edited
What changed in the outcomes
  • Time frameAssessment of Feasibility2.5 years → 1.5 years
  • DescriptionAssessment of Feasibility: how it is measured was reworded
  • DescriptionAssessment of Metabolic Outcomes: how it is measured was reworded
  • DescriptionAssessment of Patient Reported Outcomes: how it is measured was reworded
  • DescriptionAssessment of Reproductive Outcomes: how it is measured was reworded
  • DescriptionAssessment of Secondary Oncologic Outcomes: how it is measured was reworded
Oct 5, 2026
Sponsor
University Health Network, Toronto→GynOncTrials
Oct 5, 2026
Show all 1 update
  1. Oct 5, 2026
    Not yet recruiting→Recruiting
    1 site added — first site in Canada
    Show site
    • Princess Margaret Cancer Centre, University Health Network · Toronto, Canada
    Start date Aug 2025→Sep 17, 2026 (now actual)
    Primary completion Feb 2027→Feb 2029
    Eligibility 1 inclusion criterion edited; 2 exclusion criteria edited, 27 added
    What changed in the criteria
    Inclusion criteria
    • EditedDiagnosis of grade 1 or 2 endometrioid endometrial cancer or atypical hyperplasia made by either endometrial biopsy or dilation and curettage
    Exclusion criteria
    • EditedMedical co-morbiditycomorbidity with end-organ dysfunction
    • AddedHistory of suicide attempts or current suicidal thoughts or behaviours
    • AddedCurrently taking insulin or insulin secretagogue (e.g., sulfonylurea)
    • AddedDiabetic retinopathy
    • AddedGastroparesis or problems with food digestion
    • AddedHistory of tachycardia (e.g., sinus tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter, or ventricular tachycardia)
    • EditedContraindications to pIUD or tirzepatidesemaglutide.
    • AddedHypersensitive to WEGOVY or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container
    • AddedPersonal or family history of medullary thyroid carcinoma (MTC)
    • AddedMultiple Endocrine Neoplasia syndrome type 2 (MEN 2)
    • AddedPregnant or breast-feeding
    • AddedCurrent or recurrent pelvic inflammatory disease
    • AddedLower genital tract infection
    • AddedPostpartum endometritis
    • AddedUterine anomalies including fibroids if they distort the uterine cavity
    • AddedCervical malignancy
    • AddedKnown or suspected progestin-dependent neoplasia, including breast cancer
    • AddedCervicitis
    • AddedUntreated cervical dysplasia
    • AddedActive liver disease or dysfunction
    • AddedActual benign or malignant liver tumors
    • AddedSceptic abortion within the previous three months
    • AddedHypersensitivity to levonorgestrel or any of the other ingredients in the formulation or components of MIRENA.
    • AddedBacterial endocarditis
    • AddedEstablished immunodeficiency
    • AddedAcute malignancies affecting blood or leukemias
    • AddedRecent trophoblastic disease while hCG levels are elevated
    • AddedPreviously inserted intrauterine device (IUD) that has not been removed
    • AddedConditions associated with increased susceptibility to pelvic infections
    Primary outcomes 1 description edited
    What changed in the outcomes
    • DescriptionAssessment of Complete Pathologic Response: how it is measured was reworded
    Secondary outcomes 1 time frame changed, 5 description edited
    What changed in the outcomes
    • Time frameAssessment of Feasibility2.5 years → 1.5 years
    • DescriptionAssessment of Feasibility: how it is measured was reworded
    • DescriptionAssessment of Metabolic Outcomes: how it is measured was reworded
    • DescriptionAssessment of Patient Reported Outcomes: how it is measured was reworded
    • DescriptionAssessment of Reproductive Outcomes: how it is measured was reworded
    • DescriptionAssessment of Secondary Oncologic Outcomes: how it is measured was reworded
    Interventions Added Drug: Wegovy; removed Drug: Mounjaro. Arm changed Tirzepatide and Progestin Intrauterine Device→Semaglutide and Progestin Intrauterine Device
    Sponsor University Health Network, Toronto→GynOncTrials
    + 6 other changes: identifiers, verification date, oversight details, description, conditions and index terms

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT06073184
Lead sponsor
GynOncTrials
Responsible party
GynOncTrials (Dr. Sarah Ferguson, University Health Network, Toronto) — Sponsor-investigator
First posted
Oct 10, 2023
Start date
Sep 17, 2026
Primary completion
Feb 2029 (estimated)
Completion
Feb 2032 (estimated)
Last update
Oct 5, 2026

Study contacts

Vanessa Ballin
Contact
vanessa.ballin@uhn.ca
416-946-4501 ext. 3195
Rachel Soyoun Kim, MD
principal investigator · University Health Network, Toronto
Sarah E Ferguson, MD
principal investigator · University Health Network, Toronto

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Semaglutide · Levonorgestrel

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