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Mismatch-repair-deficient endometrial cancer: lines of therapy

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5 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comers
Screening, prevention and diagnosis1
Early / localised1
Second line2
Other settings1

Screening, prevention and diagnosis

SubgroupSettingApproachProducts and trialsEvidence
All comersDiagnosis and hereditary riskUniversal MMR immunohistochemistry on every endometrial cancer; MLH1 methylation testing on MLH1-deficient tumours; germline testing and cascade testing of relatives when methylation is absent.95

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersEarly stage after surgeryAdjuvant therapy by stage and risk factors as for no specific molecular profile: vaginal brachytherapy for intermediate risk, pelvic radiotherapy for high-intermediate risk; chemotherapy adds little (PORTEC-3).93

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersAdvanced or recurrent, first lineCarboplatin-paclitaxel with dostarlimab (RUBY) or pembrolizumab (NRG-GY018), continued as maintenance; durvalumab (DUO-E) is an alternative.98
All comersRecurrent after chemotherapy without prior immunotherapySingle-agent dostarlimab or pembrolizumab, with durable responses in a large minority.99

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersLynch carriersAnnual surveillance from the mid-thirties where offered, aspirin, and risk-reducing hysterectomy with salpingo-oophorectomy after childbearing.94

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.