Endometrial cancer is the most common gynaecological cancer in Australia, with an estimated 2200 women diagnosed each year. Obesity is a proven risk factor for endometrial cancer. The obesity epidemic has seen its incidence rise by 1% each year in women under 40. This type of cancer is currently under-researched.

The current standard treatment includes a total hysterectomy. While highly effective, there are side effects involved for:

  • women with severe medical co-morbidities and/or morbid obesity who are at risk for surgical complications and for whom surgery is unsafe. Comorbidity is the presence of one or more additional disorders (or diseases) co-occurring with endometrial cancer
  • young women who still wish to have children and would lose their fertility by having a hysterectomy.

feMMe aims to treat women with endometrial cancer less-invasively through the use of the Mirena, an intra-uterine device. This is the same device that is commonly used as a contraceptive (the IUD).

Metformin is the most widely used anti-diabetes drug in the world and evidence suggests it is also a powerful anti-cancer drug.  feMMe aims to treat endometrial cancer by loading the Mirena with Metformin; this treats cancer from inside the uterus. This is a far less invasive treatment than a radical hysterectomy, and allows at-risk women to avoid the complications and side effects associated with surgery. It also allows women to retain their reproductive organs.

The causal link between endometrial cancer and obesity is undeniable. Weight loss interventions are feasible and safe and are already being implemented by gynaecological oncologists to make women eligible for surgery.

This study targets a steadily increasing population of morbidly obese, young or co-morbid patients with early endometrial cancer. The gains of a successful project will include the reduction of hospital bed days, radical surgery, surgical complications and their associated costs. It will allow an increasing number of women to maintain their fertility and have children.

This study is not a research priority by the pharmaceutical industry and will not be funded by them. For further information on this trial, please email trudi.cattley@health.qld,gov.au 

feMMe Trial long term follow-up

We completed the recruitment phase of the trial in November 2019, recruiting 165 patients with early endometrial cancer (or endometrial hyperplasia with atypia) who are either a) young and wish to retain fertility or b) are unsuitable for surgery due to medical co-morbidities. Patients completed the trial in late April 2020. We are now examining long term outcomes in these patients.

Calling all feMMe participants

The last feMMe patient enrolled in the early phase of this endometrial cancer trial, finished at the Mater in late April 2020. Since then, the QCGC Research team has been data cleaning and reviewing pathology samples in preparation for data analysis  and writing reports, presentations and publications. They have also started the long-term follow-up with all participants via mail. If you participated in the feMMe trial but have not yet signed up for the long-term follow-up, please contact the clinical trial manager, Vanessa Taylor, at vanessa.taylor3@health.qld.gov.au or phone (07) 3346 5073.