{"entity":{"id":"nsmp","kind":"term","name":"No specific molecular profile (NSMP) endometrial cancer","aka":["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"],"tldr":"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.","asOf":"2026-09-17","links":[],"tags":[],"related":["endometrial-molecular-classes","pole-ultramutation","tp53-mutated","msi","hormone-receptor-status","pten-loss","lymphovascular-invasion","depth-of-invasion","ihc"],"cancers":["endometrial-nsmp"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Biomarkers"},"route":"/terms/nsmp/","neighbours":{"term":[{"id":"depth-of-invasion","kind":"term","name":"Depth of invasion (DOI)","route":"/terms/depth-of-invasion/"},{"id":"endometrial-molecular-classes","kind":"term","name":"Endometrial cancer molecular classes (POLEmut, MMRd, p53abn, NSMP)","route":"/terms/endometrial-molecular-classes/"},{"id":"hormone-receptor-status","kind":"term","name":"Hormone receptor status (ER / PR)","route":"/terms/hormone-receptor-status/"},{"id":"ihc","kind":"term","name":"Immunohistochemistry (IHC)","route":"/terms/ihc/"},{"id":"lymphovascular-invasion","kind":"term","name":"Lymphovascular invasion (LVI)","route":"/terms/lymphovascular-invasion/"},{"id":"msi","kind":"term","name":"Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)","route":"/terms/msi/"},{"id":"pole-ultramutation","kind":"term","name":"POLE ultramutation (POLEmut)","route":"/terms/pole-ultramutation/"},{"id":"pten-loss","kind":"term","name":"PTEN loss","route":"/terms/pten-loss/"},{"id":"tp53-mutated","kind":"term","name":"TP53-mutated (p53-abnormal)","route":"/terms/tp53-mutated/"}],"cancer":[{"id":"endometrial-nsmp","kind":"cancer","name":"Endometrial cancer with no specific molecular profile","route":"/cancers/endometrial-nsmp/"}]}}