Endometrial cancer
ICD-10 C54.1 · ICD-11 2C76

Treatment of High-Risk Stage IIIm–IVAm Endometrial Carcinoma with Mismatch Repair Deficiency (MMRd)

This protocol applies to a specific high-risk subset of endometrial carcinoma: patients staged IIIm–IVAm whose tumour harbours mismatch repair deficiency (MMRd). Confirmed MMRd status is a key molecular feature that directly informs adjuvant treatment strategy in this stage group.

Clinical Scenario

Endometrial carcinoma classified as high risk, stage IIIm–IVAm, with confirmed mismatch repair deficiency (MMRd). This molecular subtype is associated with a distinct treatment pathway compared with MMR-proficient tumours at the same stage.

Adjuvant Approach — Partial Overview

Adjuvant therapy in this setting involves a combination of chemotherapy and an immune checkpoint inhibitor. External beam radiotherapy may also be incorporated. The complete regimen, eligibility criteria, and sequencing are available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/S1470-2045(25)00167-6

For patients with stage IIIm–IVAm MMRd endometrial carcinoma, adjuvant chemotherapy combined with an immune checkpoint inhibitor (with or without external beam radiotherapy) should be considered (II,B; figure 5).

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