# No specific molecular profile (NSMP) endometrial cancer

Source: https://onco.cc/terms/nsmp/  
OnCo record `nsmp` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

NSMP is the label an endometrial cancer gets when the three positive tests are all negative: no POLE mutation, intact mismatch repair and normal p53. It is the largest group, mostly hormone-driven and low grade, and it is treated by stage, grade and oestrogen receptor rather than by a molecular marker.

## Summary

What is measured: a diagnosis by exclusion within the ProMisE and WHO 2020 classification. How: POLE exonuclease domain sequencing negative, mismatch repair immunohistochemistry (MLH1, PMS2, MSH2, MSH6) intact, p53 immunohistochemistry wild-type pattern. About half of endometrial carcinomas fall here, with an intermediate and heterogeneous outcome, so the group is refined by oestrogen receptor expression (ER-negative NSMP behaves like p53-abnormal disease), grade, L1CAM expression, lymphovascular space invasion, depth of myometrial invasion and CTNNB1 exon 3 mutation (higher recurrence in otherwise low-grade tumours). PTEN, PIK3CA and ARID1A mutations are frequent. What a result changes: adjuvant treatment follows the ESGO/ESTRO/ESP molecular risk groups (vaginal brachytherapy for intermediate risk, chemoradiation for high risk); advanced ER-positive NSMP disease is a candidate for endocrine therapy (progestins, aromatase inhibitors, with CDK4/6 inhibitors in trials); the RAINBO NSMP-ORANGE trial tests endocrine therapy in place of chemotherapy after radiotherapy. Where it matters: the NSMP endometrial page.

## Fields

- Kind: Term
- Last checked: 2026-09-17
- Also known as: NSMP; no specific molecular profile; p53 wild-type endometrial cancer; p53wt class; copy-number low; copy-number-low; CN-low; NSMP class; NSMP endometrial cancer; L1CAM expression

## Connected records

- terms: [Depth of invasion (DOI)](https://onco.cc/terms/depth-of-invasion/), [Endometrial cancer molecular classes (POLEmut, MMRd, p53abn, NSMP)](https://onco.cc/terms/endometrial-molecular-classes/), [Hormone receptor status (ER / PR)](https://onco.cc/terms/hormone-receptor-status/), [Immunohistochemistry (IHC)](https://onco.cc/terms/ihc/), [Lymphovascular invasion (LVI)](https://onco.cc/terms/lymphovascular-invasion/), [Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)](https://onco.cc/terms/msi/), [POLE ultramutation (POLEmut)](https://onco.cc/terms/pole-ultramutation/), [PTEN loss](https://onco.cc/terms/pten-loss/), [TP53-mutated (p53-abnormal)](https://onco.cc/terms/tp53-mutated/)
- cancers: [Endometrial cancer with no specific molecular profile](https://onco.cc/cancers/endometrial-nsmp/)

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JSON: https://onco.cc/api/v1/entities/nsmp.json