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Long-term control for > 9 years with megestrol acetate-letrozole: metastatic endometrioid carcinoma case report

Year: 2026
Type: article
Study design: Case Report
Abstract: Background: Hormone receptor-positive (HR+) endometrial carcinoma (EC) responds to endocrine therapy, but clinical benefit duration is often limited, especially in patients with widely metastatic or recurrent disease. Case: A 54-year-old woman with HR-high (ER/PR 90%) metastatic EC (FIGO IIIC2) discontinued adjuvant chemotherapy due to severe toxicity. She initiated megestrol acetate and letrozole in March 2017, achieving stable disease (SD) for 38 months. Self-discontinuation (January-July 2020) led to disease progression (new retroperitoneal lymph nodes), but resuming full-dose therapy restored SD for 49 months. After dose reduction (July 2023), the disease progressed again at 12 months; re-escalation to full dose induced regression. At last follow-up (OS: 108 months), she maintained SD with minimal toxicity. Conclusion: This is the first case demonstrating that full-dose megestrol acetate plus letrozole may induce durable antitumor activity in HR-high expression metastatic EC, warranting prospective validation.
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7131243992
FWCI:
Cites: 21
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