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.
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 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.
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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